Does value-based healthcare support patient-centred care? A scoping review of the evidence

BackgroundStandardisation of outcome measures is integral to value-based healthcare (VBHC), which may conflict with patient-centred care, focusing on personalisation.ObjectivesWe aimed to provide an overview of measures used to assess the effect of VBHC implementation and to examine to what extent the evidence indicates that VBHC supports patient-centred care.DesignA scoping review guided by the Joanna Briggs Institute methodology.Sources of evidenceWe searched the following databases on 18 February 2021: Cochrane Library, EMBASE, MEDLINE and Web of Science.Eligibility criteriaWe included empirical papers assessing the effect of the implementation of VBHC, published after introduction of VBHC in 2006.Data extraction and synthesisTwo independent reviewers double-screened papers and data were extracted by one reviewer and checked by the other. We classified the study measures used in included papers into six categories: process indicator, cost measure, clinical outcome, patient-reported outcome, patient-reported experience or clinician-reported experience. We then assessed the patient-centredness of the study measures used.ResultsWe included 39 studies using 94 unique study measures. The most frequently used study measures (n=72) were process indicators, cost measures and clinical outcomes, which rarely were patient-centred. The less frequently used (n=20) patient-reported outcome and experience measures often measured a dimension of patient-centred care.ConclusionOur study shows that the evidence on VBHC supporting patient-centred care is limited, exposing a knowledge gap in VBHC research. The most frequently used study measures in VBHC research are not patient-centred. The major focus seems to be on measures of quality of care defined from a provider, institution or payer perspective.

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A values-driven academic affiliation between a public medical school and a private healthcare provider: exploring the perceptions of key opinion leaders

Du Preez,

Otaki,

Clemens

et al. 2024

Preprint

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In an Academic Health System model where university and clinical care institutions are separate entities, robust agreements are needed for effective working relationships among the involved institutions. There is paucity in the literature around reports of such affiliations, especially those relating to public private partnerships. Accordingly, the overall purpose of this study is to explore the perception of key opinion leaders about the development of a values-driven affiliation between a public medical school and a private healthcare provider in an Academic Health System in Dubai, United Arab Emirates. The process of developing the respective affiliation was based on the principles of action research. It involved ongoing cycles of planning, acting, observing, and reflecting. This study relied on a qualitative phenomenological research design, where 18 primary stakeholders, who played an active role in making the affiliation, were given the option of providing their feedback either in writing, using a tailor-made questionnaire, or in the form of a semi-structured interview. Constructivist epistemology constituted the basis of the entailed interpretive qualitative analysis, which followed the six-step analysis approach initially introduced by Braun and Clarke (2006). The qualitative analysis led, as per this study’s conceptual framework: ‘Public Private Affiliation Journey’, to two interconnected themes, namely: Key Milestones and Driving Forces. Within Key Milestones, seven sequential categories were identified: Observing a triggering need, Finding a good match, Seizing the opportunity, Arriving at a common ground, Looking ahead, Venturing for the right reasons, and Reaping the benefits. Within the second theme: Driving Forces, the following three categories were identified: Aspiring for success, Leveraging human qualities, and Doing things the right way. This study showed that there is a latent potential in forming public private partnerships that can enable the formation and development of Academic Health Systems. It also showcased how the guidelines of action research can be set as the basis of the process of partnership formation, and how following those guidelines in such an endeavor maximizes value for all. Lastly, this study introduced the ‘Public Private Affiliation Journey’ conceptual framework, which can be deployed in ‘federated’ Academic Health Systems worldwide to increase the chances of success of public private partnerships and to maximize the value attained through them.

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Does value-based healthcare support patient-centred care? A scoping review of the evidence

Cited by 6 publications

References 60 publications

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Patient-Reported Experience Measures to Evaluate and Improve the Quality of Care in Nephrology

Does value-based healthcare support patient-centred care? A scoping review of the evidence

A values-driven academic affiliation between a public medical school and a private healthcare provider: exploring the perceptions of key opinion leaders

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